The Care Bill is heading for the statute books after clearing its latest Parliamentary hurdle, in which a government amendment was passed to introduce a system to handle appeals council care decisions.
The bill was also amended to enforce the pooling of health and social care budgets through the Better Care Fund (BCF), which will oblige councils and clinical commissioning groups (CCGs) to bring together £3.8bn in 2015-16 to integrate care.
However, in the final session of the bill’s committee stage in the House of Commons yesterday, care minister Norman Lamb resisted the latest attempt to introduce a power for social workers to enter homes where abuse of a vulnerable adult is suspected but entry barred by a third party.
A committee of MPs has been scrutinising the bill in detail over the past month; but though Lamb has been challenged on the government’s approach to several aspects of the legislation, amendments made during the committee have been at his initiation.
The Care Bill will now proceed to its report stage – a debate on the floor of the House of Commons, which provides the last opportunity for MPs to amend the bill – and then to its third reading, where MPs will be asked to vote on the full bill. These two stages will be concluded within two days and then the House of Lords will be asked to agree any changes made in the Commons before the bill passes into law.
Appeals against local authorities
In yesterday’s debate, Lamb said the provision to introduce an appeals process was designed to bolster public confidence in the new legal framework introduced by the bill by enabling them to “challenge [council] decisions without resorting to judicial review”. He said it was important that the system had “a degree of independence” from the local authority to convince people it was “fair and unbiased”.
However, he said the details of the appeals system are yet to be worked out and the amendment to the bill had been framed to give ministers flexibility over which system to adopt. He suggested an existing statutory body might be tasked with handling the appeals process.
The government amendment to enshrine the BCF in law would enable the government to mandate NHS England to set aside resources to further integration, and that this should be allocated to CCGs to pool budgets with councils.
NHS England would also be able to withdraw or remove part of the funding from CCGs if performance targets attached to it were not met. Though it would then have to use the money for the purposes of integrating care, this could involve transferring the resource to other areas.
Safeguarding power debate
Former care minister Paul Burstow made the latest in a number of efforts to give social workers the power to apply to a judge for permission to enter homes where they suspect a vulnerable adult is being abused but entry is barred by the abuser, typically a family member.
In response to concerns raised by mental health charity Mind that such a power may override patient autonomy, Burstow had increased the number of checks and balances in his proposal. In particular, the social worker concerned would have to show the judge hearing the application that they had reasonable cause to suspect that the suspected victim was “unable to make decisions freely” before an order could be granted.
Burstow said that this would “make it clearer that this power relates to circumstances where a third party is preventing access and in some way compromising a person’s autonomy”.
However, Lamb yet again rejected the proposal, citing submissions from the Association of Chief Police Officers (ACPO) and the Association of Directors of Adult Social Services that it was unnecessary and would undermine good social work.
Lamb said that ACPO was satisfied that the police had “sufficient powers of entry to protect people from harm”, both under common law and the Police and Criminal Evidence Act 1984, which allows officers to enter homes in order to protect “life or limb”.
Separately, Adass had warned that the proposed power would “encourage a coercive rather than negotiated approach to complex and difficult situations” and increase the risks of abuse or harm facing the people concerned.
Lamb has already said that social workers would receive guidance on the use of existing powers to safeguard people, in response to an apparent lack of awareness among practitioners.
Burstow declined to push his amendment to a vote but said he would raise the issue again at the report stage of the bill.